Provider Demographics
NPI:1316298573
Name:NGASSA, MBIAKOUP E (HOME HEALTH AIDE)
Entity type:Individual
Prefix:MRS
First Name:MBIAKOUP
Middle Name:E
Last Name:NGASSA
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BURNT MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4504
Mailing Address - Country:US
Mailing Address - Phone:202-528-1207
Mailing Address - Fax:
Practice Address - Street 1:500 BURNT MILLS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:202-528-1207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA8172374U00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide